Jeanette Marie Silva, COTA
Individual provider Active NPI Contractor · Bovina, TX
NPI 1649520552 · NPPES record last updated Sep 18, 2012
Key facts
- NPI
- 1649520552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 211762 (TX)
- Practice address
- 705 9TH St
Bovina, TX 79009-0093 - Phone
- (575) 693-7510
- NPI assigned
- Sep 18, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 211762 | TX | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 211762 | TX | Yes |
Addresses
Primary practice location
705 9TH St
Bovina, TX 79009-0093
Mailing address
705 9TH St
Bovina, TX 79009
Phone (575) 693-7510
Other providers in Bovina, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.